Promising early results for CMS' nursing home-hospital admissions program

A federal initiative to reduce preventable hospital admissions among nursing home residents has returned encouraging early results, according to a new report.

In 2014, the second year of the Centers for Medicare & Medicaid Services initiative, Medicare expenditures fell for all seven demonstration sites. Additionally, all-cause hospitalizations and potentially avoidable hospitalizations fell across sites.

"As we plan for new Medicare payment incentives to reduce hospital readmissions from skilled nursing facilities, these results provide early indications that when the right strategies are in place, they may effectively reduce hospitalization rates and reduce overall Medicare spending," Patrick Conway, M.D., CMS' principal deputy administrator and chief medical officer, said in a blog post.

At the state level, the report found more mixed results, with stronger progress in Indiana, Alabama and New York, compared to less consistent results in Nevada and Nebraska. Hands-on intervention models also generated stronger results than the purely educational models, but at a steeper cost.

Since January 2011, 95 percent of respondent facilities said they have introduced polices aimed at reducing avoidable hospitalizations, such as rate tracking or working to standardize communication between nurses and doctors. "These preliminary results indicate that a great majority of comparison group facilities--and in many states, all facilities--have been engaged in practices related to the Initiative in the past four years," the report states.

CMS rolled out the second phase of the initiative last September, soliciting applications from first-round participants to test a new nursing home payment model that offers incentives for treatment of conditions that could otherwise lead to hospitalization, FierceHealthcare previously reported.